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Iopamidol for intrathecal use in pediatric neuroradiology
R Ruggiero1, G Piscitelli, A Ambrosio
1Department of Pediatric Neurosurgery, Santobono Hospital, Naples, Italy.
Insights
Lower concentrations of iopamidol (iodine 150 and 200 mg/ml) significantly reduce side effects in pediatric neuroradiology procedures. These concentrations offer preserved contrast and fewer adverse reactions compared to higher concentrations.
Area of Science:
- Pediatric Radiology
- Neuroradiology
- Medical Imaging
Background:
- Iopamidol is a non-ionic contrast medium used in various radiological procedures.
- Assessing the safety and efficacy of different iopamidol concentrations in pediatric patients is crucial.
Purpose of the Study:
- To evaluate the safety and effectiveness of iopamidol at varying iodine concentrations (150, 200, and 300 mg I/ml) in pediatric neuroradiology.
- To determine optimal concentrations for specific neuroradiologic procedures in children.
Main Methods:
- A clinical trial involving 947 children (1 day to 14 years) undergoing computed tomography (CT) cisternography, CT ventriculography, CT myelography, and conventional myelography.
- Administration of iopamidol at iodine concentrations of 150, 200, and 300 mg I/ml.
- Monitoring of vital signs, neurologic status, and adverse events up to 72 hours post-examination.
Main Results:
- No significant changes in vital signs or neurologic status were observed.
- Psychic agitation was the most common side effect, related to the procedure type.
- Lower concentrations (150 and 200 mg I/ml) resulted in a ~50% reduction in side effects.
- Iopamidol 150 and 200 mg/ml were optimal for CT enhancement, reducing artifacts.
- 300 mg I/ml concentration yielded the best results in conventional radiology.
Conclusions:
- Lower concentrations of iopamidol (200 and 150 mg I/ml) are effective in pediatric neuroradiology.
- These lower concentrations provide preserved contrast enhancement while significantly reducing adverse reactions.
- Iopamidol at 150 and 200 mg I/ml represents a favorable option for pediatric neuroradiologic imaging.
Abstract:
A clinical trial using iopamidol, a non-ionic contrast medium, in various iodine concentrations (300, 200 and 150 mg I/ml), was carried out in 947 children, aged between 1 day and 14 years, who underwent various neuroradiologic procedures: computed tomography (CT) cisternography (n = 307), CT ventriculography (n = 203), CT myelography (n = 153), and conventional myelography (n = 284). No significant variation in vital signs and neurologic status was recorded during and up to 72 hours after the examination. Psychic agitation was the major effect registered, being clearly related to the type of procedure used. A significant reduction of untoward side effects (about 50%) was observed using the lower concentrations of the medium. Iopamidol 150 mg and 200 mg represented the optimal concentration for CT enhancement, these concentrations reducing artifacts; the 300 mg I/ml concentration gave best results in conventional radiology. It seems that the lower concentrations of iopamidol (200 and 150 mg I/ml) can be usefully employed in pediatric neuroradiology, with preserved contrast and dramatically reduced untoward reactions.